Path of Medicine With a System
chapter-157

Zhang Fan didn’t really want to go to the nurses’ resting area, as he would feel too awkward, but the nurse was being really passionate and friendly, so he wouldn’t be giving face to her if he refused. Zhang Fan thus forced himself to enter the nurses’ resting area which was usually for women only. The nurses’ resting area was cleaner than the doctors’ resting area, and also had a nice faint fragrance. Zhang Fan decided to make do and rest for a while here. However, he then discovered that even the pillows here were scented. Zhang Fan really couldn’t take this, and was unable to sleep a single wink all morning.

For the neurosurgery department’s daily morning meeting, Liu Zhaoyun was having a difficult time with his fatigue as he had barely gotten any sleep all night. He only sat there listlessly. Zhang Fan and Xia Huadong were in slightly better condition despite the all-nighter since they were much younger. After Liu Zhaoyun arranged the department’s work for the day, he needed to first talk to the rich people waiting outside the department for news about Dai Wengang before starting the patient checkups. This was all because of the power of money.

Zhang Fan had only been in Chasu City for a year. He had no idea who any of the rich people were, and didn’t really care. After the patient checkups ended, Zhang Fan went over to the intensive care unit department. Although there were ICU doctors and nurses on duty 24 hours a day there, Zhang Fan still couldn’t rest assured. He had to see the patient Dai Wengang for himself. Dai Wengang was doing pretty good. His vitals were all stable, and he didn’t have a fever. Luckiest of all, he didn’t suffer from epilepsy, which was one of the most common side effects of brain injuries.

Zhang Fan returned to his apartment and texted Shao Hua that he was going to sleep. However, he didn’t dare to turn off his cell phone as he slept, because Dai Wengang was still at risk. A phone call might come for him at any moment. Regardless, Zhang Fan slept! It really felt nice to finally sleep in his own bed after such a tense night. This was bliss to him, comfortably sleeping in his bed with the curtains closed after an all-nighter of hard work!

Li Liang resigned from Kuake City Hospital. He had to because he saw no hope there at all. His family also supported him. It wasn’t like his family needed Li Liang to financially support them. They said he only needed to find a job that he liked.

Ma Wentao was paying extra attention to surgery ever since he saw how much profit surgery could bring him. Money could always make people go crazy!

Why did it seem like many surgeries at hospitals didn’t make money? That was because the hospital would have lots of expenses with medical equipment, medicine, rent, construction, and so on. The Chinese government had paid for all of this in public hospitals, so the hospital would need to pay the government some money back every month. There were also many surgeries that didn’t use much medicine or medical equipment, which meant that the doctors wouldn’t be able to receive much in kickbacks, so the doctors would be unwilling to perform such surgeries.

For instance, limb replantation surgery. Reattaching a single severed finger would cost the patient approximately 7000-8000 yuan for the surgery fee. However, the doctor would only be paid a base amount of 20 yuan for performing one surgery along with bonuses. This meant that the doctor would only earn about 100 yuan for performing a limb replantation surgery, because this type of surgery used almost no medical equipment. Not only that, limb replantation surgeries were really long—it was common for such a surgery to take a minimum of three to four hours. And most importantly of all, more than 90% of limb replantation surgery patients would come in for emergency treatment. The doctor would also need to worry for quite a long while after the surgery about the patient’s condition. This was why few doctors would be willing to perform limb replantation surgery.

This was why the market for limb replantation surgery was left to private hospitals instead of public hospitals. Ma Wentao’s way of improving business for his hospital was rather flashy, but his methods were indeed effective.

Chen Qifa brought Li Liang over to meet Ma Wentao, who offered to hire Li Liang for 5,000 yuan per month as salary. Li Liang instantly turned around to leave, but Ma Wentao stopped him. Ma Wentao now knew that those who were connected to Zhang Fan would at least be alright in skill level. In the end, he and Li Liang agreed upon a base salary of 5,000 yuan per month, but Li Liang would also earn 3% of the surgery fee, and Chen Qifa would earn 5% of the surgery fee. Li Liang was also given an apartment to live in for free while he worked for Ma Wentao.

Ma Wentao had to plan for how to improve his hospital’s market share. Although the mine owners and government were willing to give face to Ma Wentao, the city hospitals and their doctors would never give him any face. Not only was he just a second-generation rich kid, it wouldn’t be of any use even if he was the first generation. There were far too many shady dealings involved in all of this. What could be done about things that power couldn’t affect? Open the path by using money!

Ma Wentao’s employees began searching all throughout city hospitals, smaller village hospitals, and even private clinics. They searched every type of facility that had medical treatment. Ma Wentao’s employees told the doctors at these facilities that they could receive 30% of the total surgery fee for sending any limb replantation surgery patient to Ma Wentao’s hospital. Ma Wentao promised to pay in full the moment that the patient was discharged.

This was crazy! The surgeons all over Chasu City went crazy with this opportunity from Ma Wentao. The great majority of hospitals really disliked having to take limb replantation surgeries. Now that a new hospital was even willing to pay them to give their limb replantation surgery patients away, every single doctor paid especially close attention to see if they could find any limb replantation surgery patients.

The first limb replantation surgery patient soon arrived at Ma Wentao’s hospital! He was a young man who was about 20 years old. This afternoon, he had been cutting grass to feed the livestock that his family owned when he accidentally cut off three fingers on his left hand. He was brought to a local city hospital. The doctor who received him at that hospital immediately transferred the patient to Ma Wentao’s hospital due to the 30% total surgery fee promise.

A bit more than two hours had passed since the accident by the time that the patient was brought to Ma Wentao’s hospital. Limb replantation surgeries could be considered somewhat difficult. Not only would limb replantation surgeries take several hours to perform, if the surgeon’s techniques weren’t good enough, it would be unlikely for the fingers to be successfully reattached, and even if the surgeon could reattach the fingers, the fingers might no longer be movable if the surgeon wasn’t skilled enough at reattachment.

Human fingers weren’t like plants. They wouldn’t regrow after being cut off. Limb replantation surgery was a type of microsurgery. There would be tools and medical equipment necessary for performing this type of microsurgery. First, a microscope that could change from anywhere between 6x to 30x magnification would be required. The microscope would also need to be able to maintain clear vision when changing magnification without needing to adjust the focal vision. Two sets of mirrors would also be required, one each for the surgeon and surgical assistant, in addition to a cold light source.

Zhang Fan had a good sleep, then went over to Shao Hua’s home and had dinner there. Shao Hua’s father no longer forced Zhang Fan to play Chinese chess with him, which really relieved Zhang Fan. More relatives such as Shao Hua’s aunts would also come over whenever Zhang Fan was present to say hi to him.

Zhang Fan and Shao Hua were just about to go out for a walk together after dinner when Zhang Fan received a phone call from Ma Wentao. “Doctor Zhang, where are you? Hurry over as fast as you can! A major surgery has arrived. You’ll need to personally take this surgery.”

“I’m currently at my girlfriend’s home. What surgery is it?”

“The patient accidentally cut off three of his own fingers! He’s already in our operating room. Give me your current address. I’ll come pick you up.” Zhang Fan told Ma Wentao the address and then smiled apologetically at Shao Hua.

“How about I walk with you to the entrance of our neighborhood, then? You need to pay more attention to yourself. Don’t overwork yourself. You just had an all-nighter yesterday, and now you’re being called in for another major emergency surgery. There’s no need to work so hard. Our salaries combined are more than enough already to support us well!” Shao Hua felt bad for Zhang Fan as she straightened his shirt for him.

“It’s fine, I’m still young! I also love to perform surgeries. Rest assured, I’ll definitely rest when I’m tired. It’s just that I’m sorry that I don’t have time to spend with you. I’ve been so busy recently that I barely get to accompany you!”

“We’ll have plenty of time in the future. There’s no worry. Let’s go, I’ll walk with you to the neighborhood entrance.”

Chasu City wasn’t that large. It was only a few minutes as they stood at the neighborhood entrance before Ma Wentao arrived. He personally drove his Mercedes Benz in order to pick up Zhang Fan. The Mercedes Benz was box-shaped and seemed a bit like a matchbox on wheels!

“How is it? Are you satisfied that I’m your personal driver?” Ma Wentao was beginning to joke around with Zhang Fan after becoming more familiar with him.

“Does the patient have a cut injury or crush injury?” Zhang Fan ignored Ma Wentao’s joke, and only cared about the surgery.

“According to Director Chen, it’s a cut injury. I didn’t dare to look at the patient. He came with his hand already wrapped in gauze. A local city hospital already gave him preliminary treatment.” Ma Wentao pouted because Zhang Fan was so boring.

There were countless people in the border province who wanted to become friends with someone as rich and influential as Ma Wentao. However, Zhang Fan wasn’t giving him any face at all, which made him feel rather defeated. ‘Could it be that my father’s position still isn’t high-ranking enough?’

Ma Wentao’s father was already one of the highest-ranking government officials in the entire border province. However, Zhang Fan actually had no clue about this!

Chen Qifa and Li Liang had already begun the disinfecting by the time that Zhang Fan arrived in the operating room. Zhang Fan took a look at the patient’s cut off fingers. Things were actually quite lucky! The fingers had cut injuries with clean cuts. The cut off fingers had also been preserved well by the local city hospital.

Special techniques were needed in order to properly preserve cut off fingers for reattachment. A small, dry, and refrigerated environment would be the best. However, the cut off fingers definitely couldn’t be allowed to come into direct contact with ice, as that would cause frostbite to the fingers. The fingers also couldn’t be soaked in any liquids at all. Fingers were different from preserved vegetables!

The three cut off fingers had already been marked and placed in a refrigerator specially set to four degrees Celsius. For reattaching cut off fingers, every second and minute would be critical. The more time passed, the lower the success rate would be for successful reattachment. As time passed, the muscle tissue in the nearby area would release a large amount of potassium, myoglobin, peptides, and other toxic substances into the bloodstream, causing the entire body to have symptoms of poisoning.

Zhang Fan washed his hands and disinfected. He put on surgical garb and joined the operating table. He directly began the surgery without saying anything. “Injury cleaning!” Zhang Fan simply announced. Chen Qifa and Li Liang were quite accustomed to Zhang Fan’s habits during surgery. He would never say anything unnecessary, and what words he said were always short and to the point.

Zhang Fan began to clean the injury. During this process, he already located the blood vessels, nerves, and muscle tendons that he needed to repair. For limb replantation surgery, the first step would be to affix the broken bone, and adjust the ossature as necessary based on the degree of injury. This step was critically important. If the skeletal framework wasn’t adjusted properly to match the cut off fingers, this would affect the recovery of all other tissue in the area. Additionally, this surgery needed to be performed swiftly because there were three cut off fingers, not just one!

Each finger would count as an individual surgery. When choosing which finger to save first, the one with the lightest injury would always be picked. This was because the principle of limb replantation when several fingers were severed was to always first save the fingers that were easiest to save and repair. As for bone fixation, the public hospitals would typically use finger metal plates. Meanwhile, the private hospitals typically used Kirschner wires or steel wires. Chinese private hospitals were actually ahead of Chinese public hospitals in this field.

Zhang Fan acted quite swiftly. For a cut injury like this, he instantly connected two interconnecting Kirschner wires by using an electric drill. Finger bones were flat bones, so the surgeon would need to be extremely careful with the electric drill. Using just slightly too much force would easily shatter the finger bones!

For tendon sutures, the surgeon would need to pick only the tendons with the most important functions to repair. The others didn’t need to be sutured. To explain this surgery simply, the surgeon was racing against time with the cells which were beginning to decay. Whoever was faster would be the “winner”.

Blood vessel sutures were by far different from tendon sutures as blood vessels were way more fragile. The surgeon could pinch the bones and tendons, but blood vessels didn’t work this way. Blood vessels would cause lots of trouble for the body if the inside of a blood vessel was damaged. Even if you sutured a blood vessel, it might still become a dead blood vessel. Why was this? If the inside of a blood vessel was damaged, it would automatically block the damaged part by itself. This was why suturing and repairing blood vessels was rather time-consuming! Bone fixation and tendon suturing could be performed with the naked eye, but blood vessel repairing could only take place with the assistance of a microscope.

The final part of limb replantation surgery would be nerve sutures. Zhang Fan’s System was truly powerful. It would be impossible for any normal doctor to be able to successfully perform nerve sutures without a minimum of five years of work experience in microsurgery. However, Zhang Fan was someone who was willing to grind for an incredible amount through his System’s training. He had already performed microsurgery countless times! The number of microsurgeries he performed already would probably be more than enough to qualify him to be the vice director of the microsurgery department in a Class A Hospital here in the border province! Zhang Fan’s experience with such a number of surgeries was the best evidence of his dedication to grinding.

Zhang Fan, Chen Qifa, and Li Liang finished reattaching the first finger. However, this was only the first step as two more fingers remained. Chen Qifa’s eyes were already beginning to hurt after he worked as the primary surgical assistant on the first finger surgery. Microsurgeries were too hard on the eyes. He was getting old. Was this cruel? Surgery was indeed such a cruel field. Older surgeons would always see their abilities begin to decline.

Chen Qifa truly felt pained as he asked Li Liang to be the primary surgical assistant starting on the second surgery. At this time, Zhang Fan couldn’t spare any time to console Chen Qifa, because there were still two more fingers to reattach. The surgeries continued. There was also no time right now to explain postoperative care for limb replantation surgery to them. He would first finish the surgeries before talking to them.

A bit more than three hours later, all three finger reattachment surgeries were now finished. This surgery had been completed while sitting on stools. Zhang Fan had his head lowered for almost the entire duration of all the hours spent performing surgery. Now that the surgery was finally over, he stretched his really sore neck.

“You must pay close attention to changing the medicine on time. You absolutely can’t let the injuries become infected. Make sure not to accidentally burn the patient’s skin with the side lamp. The injured fingers must remain at a higher level than the heart. The patient is strictly forbidden from smoking. Nobody is allowed to smoke in the patient’s room, either. The repaired blood vessels are quite tiny. It will be bad if they go into convulsions!” Zhang Fan gave Li Liang a detailed explanation on how to perform postoperative care for the limb replantation surgery patient.

Zhang Fan then took off his surgical garb. He was in no hurry to go talk to Ma Wentao yet. He pulled on Chen Qifa as both sat together on the ground of the operating room. Chen Qifa was really dejected. Zhang Fan wanted to console him, but didn’t know what to say.